The global obesity epidemic now costs the world economy more than alcoholism or climate change, study says.

Obesity is now a threat to the world economy to rival war and terrorism, according to a new report published Thursday.

Taking together the costs of healthcare, of lost productivity and other spending needed to mitigate its impact, consulting firm McKinsey reckons the annual cost of obesity fat now tops $2 trillion, or 2.8% of global economic output. That compares with an estimate of $2.1 trillion for war and terrorism, and for smoking, and is way ahead of alcoholism ($1.4 trillion), illiteracy ($1.3 trillion) and even climate change ($1.0 trillion).

The report is the latest evidence of the spiralling costs of unhealthy lifestyles that combine low levels of exercise (often due to desk-based jobs) with a taste for fatty and sugary foods. And while the problem may have originated in the U.S. and other rich economies, it is now firmly entrenched and growing fast in many countries that are, by most standards, still poor.

The U.N.’s World Health Organization estimates that over one in three adults was overweight in 208, while more than one in 10 was obese. Twice as many people worldwide live in countries where more die from being too fat than from being undernourished. The most frequent causes of death include heart disease and type-2 diabetes. McKinsey estimates that almost half the world’s adult population could be obese or overweight by 2030 if current trends continue.

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